Smoking surcease or baccy surcease can be defined as wide scope of enterprises that assist current tobacco users to decrease their smoke wont ( Campaign for Tobacco-Free Kids, 2001 ) . However, in another context, smoking surcease is defined as assortment types of aid and intervention that can be offered by wellness practicians including doctor and druggist straight to tobacco users in order to help them to discontinue or cut down smoke ( Campaign for Tobacco-Free Kids, 2001 ) . In Malaysia, there are a broad scope of smoking surcease aid provided such as pharmacotherapy like Nicotine Replacement Therapy ( NRT ) and bupropion, quit smoke clinic in which about 300 quit clinics can be available about in every territory in Malaysia, infoline, quitline and educational stuff such as posting, booklet and brochure ( Samsudin et al. , 2008 ) . Many smoking surcease programmes, schemes and runs were conducted in this state in order to increase people knowledge on bad hazards of smoke and to inform them assorted sorts of aids available to assist them cut down smoking wellness hazards and to halt smoke. However, to guarantee effectivity, we have to supervise their cognition whether they are better informed and understand or non. Some people may hold incorrect information on this. Some may hold the cognition, but they do non transform it into belief. Some did non have information on this. Therefore, this could be a barrier for them to discontinue smoke or to cut down smoking wellness hazards.
Although there are many smoking surcease schemes and programmes held in this state, there are still a batch of people that have information missing sing the bad hazards of smoke and smoke surcease available in Malaysia. However, there are some people that think that they have adequately informed about smoke, but many of them, really have a incorrect information or misperception on this. For illustration, some tobacco users have misperception that nicotine is the primary cause of tobacco-related wellness job. As a effect, this misperception on nicotine may do them to afraid in sing the use of nicotine replacing therapy in discontinuing smoke.
The chief aims of this research are to find the differences in the degree of cognition between current tobacco users, former tobacco users and non-smokers in Universiti Teknologi Mara ( UiTM ) Puncak Alam and Shah Alam on smoking wellness hazard and smoking surcease aid available in Malaysia, to find the relationship among demographic and smoke position variables and the different cognition indices and to find the relationship among different degree of dependence of current tobacco users and the different cognition indices.
The consequence of this survey will help the effectiveness attack of the current smoke surcease schemes and programmes held by authorities and non-government establishment to increase cognition and to supply more information on the jeopardies of smoke and smoke surcease aid available in Malaysia.
There are significance differences in the degree of cognition on smoking wellness hazards and smoking surcease between current tobacco users, former tobacco users and non tobacco users and besides between different demographics, smoking position and degree of dependence of current tobacco users. Former tobacco users and current tobacco users that believe will halt smoke following twelvemonth, that of all time use any of the smoke surcease aid and that have low degree of nicotine dependence will be more knowing on the wellness hazards of smoke and smoke surcease aid provided in Malaysia.
2.1 Prevalence of smoke
Presently, approximately 1.3 billion people smoke and more than five million people die globally as a consequence of smoke every twelvemonth ( Jilan et al. , 2010 ) . In the bulk of high-income states, there is a important decrease in baccy ingestion ( Disease Control Division, 2003 ) . For illustration, the prevalence of smoke among Americans in the United States of America had reduced from 40 per centum in 1964 to 23 per centum in 1997 ( Disease Control Division, 2003 ) . However, in developing states including Malaysia, there is contrast prevalence with high-income states in which there is an addition in baccy ingestion ( Disease Control Division, 2003 ) . In Malaysia, there is an addition in the prevalence of smoke among grownups aged 15 old ages and above from 21 per centum in 1985 to 31 per centum in 2000 ( Disease Control Division, 2003 ) . Current tobacco users constitute five per centum of all grownup females and 49 per centum of all grownup males ( Disease Control Division, 2003 ) . As the population grows, the prevalence of tobacco users will go on to increase ( Disease Control Division, 2003 ) . In Malaysia, there are about five million tobacco users in which each of them is utilizing an norm of 14 coffin nails daily ( Disease Control Division, 2003 ) . From this prevalence, 90 per centum comprise of male ( Disease Control Division, 2003 ) .
Whereas, the prevalence of smoke among adults age 18 and above in Malaysia that is obtained from three National Health and Morbidity studies which have been conducted since 1986 were more than 20 per centum, 21.5 per centum in 1986, 24.8 per centum in 1996 and 22.8 per centum in 2006 ( Lim et al.,2009 ) . In China, there are more than 70 per centum of all Chinese, or more than 600 million Chinese people are often exposed to secondhand fume or inactive fume ( Jilan et al. , 2010 ) .
2.2 Chemicals Contained in Cigarette
Cigarettes are the simply marketed consumable merchandise in which when it is used as intended, it may take to the decease of half or more of its users ( Corelli & A ; Hudmon, 2009 ) . Harmonizing to Corelli & A ; Hudmon ( 2009 ) , coffin nails are carefully engineered preparations that optimize the nicotine bringing, in which nicotine is a chemical that meets the feature for an habit-forming substance. Polycyclic aromatic hydrocarbons are identified to show in big sums in baccy fume and are accountable for most drug interactions with smoke ( Corelli & A ; Hudmon, 2009 ) . Other substances in baccy fume such as pyridines, benzine, propanone, nicotine, heavy metals and C monoxide might look to hold less important effects to interact with hepatic enzymes ( Corelli & A ; Hudmon, 2009 ) .
Tobacco smoke is accountable for about 80 per centum of lung malignant neoplastic disease instances ( Wells et al. , 2009 ) . Exposure to environmental baccy fume is the most common etiology that can take to Chronic Obstructive Pulmonary Disease ( Wells et al. , 2009 ) . Inhalation of harmful atoms and gases into the human organic structure may trip the activation of macrophages, neutrophils and CD8+ lymph cells ( Wells et al. , 2009 ) . As a consequence of this activation, a assortment of chemical go-betweens such as leukotriene B4, tumour mortification factor-I± and interleukin-8 are released and eventually, lead to widespread destructive changes in the air passages, lung parenchyma and besides pneumonic vasculature ( Wells et al. , 2009 ) . In add-on, oxidant gases and other substances in the coffin nail fume are believed to excite a hypercoaguble province identified by elevated thrombocyte collection and thrombosis, taking to elevated hazard of myocardial infarction and sudden decease ( Corelli & A ; Hudmon, 2009 ) . Whereas, the C monoxide in contained in coffin nail fume decreases the measure of O available to weave and organ including myocardial tissue, therefore diminishing the threshold of ventricular fibrillation ( Corelli & A ; Hudmon, 2009 ) . It could besides rush coronary artery disease through its effects on serum lipoids, as a consequence, tobacco users have a inclination toward higher degrees of entire cholesterin, triglycerides, LDL-C and lower HDL-C compared to nonsmokers ( Corelli & A ; Hudmon, 2009 ) . The increased degrees of inflammatory go-betweens caused by smoke may besides lend to atherosclerosis ( Corelli & A ; Hudmon, 2009 ) . Whereas, the initiation of neurotransmitters release including adrenaline and noradrenaline caused by smoke may heighten myocardial work load and trigger coronary vasoconstriction that can take to arrhythmias, ischaemia and sudden decease ( Corelli & A ; Hudmon, 2009 ) .
Addiction of nicotine is one signifier of chronic encephalon unwellness that consequences from alterations in encephalon chemical science ( Corelli & A ; Hudmon, 2009 ) . The rapid soaking up of nicotine contained in baccy merchandises and their transition across the blood-brain barrier contributes to its habit-forming nature ( Corelli & A ; Hudmon, 2009 ) . Nicotine can make the encephalon merely within seconds by inspiration of coffin nail fume ( Corelli & A ; Hudmon, 2009 ) . After being absorbed, nicotine stimulates a widespread of cardinal nervous system, cardiovascular and metabolic effects and induces several neurotransmitters release such as Dopastat, hence stimulates the immediate feelings of pleasance, together with alleviation of the nicotine backdown symptoms ( Corelli & A ; Hudmon, 2009 ) . The celerity of this dose response reinforces repeated drug disposal and perpetuates the smoke behaviour ( Corelli & A ; Hudmon, 2009 ) . Chronic nicotine disposal has been proven to ensue in a higher sum of nicotine receptors in specific compartment in the encephalon and this is believed to qualify upregulation in response to nicotine-mediated desensitisation of the receptors and it play a undertaking in tolerance and dependance of nicotine ( Corelli & A ; Hudmon, 2009 ) .
Unusually, the tobacco user experiences marked pharmacologic effects, particularly arousal, after smoking the first coffin nail of the twenty-four hours ( Corelli & A ; Hudmon, 2009 ) . There are no other coffin nails throughout the twenty-four hours that will bring forth the similar grade of rousing ( Corelli & A ; Hudmon, 2009 ) . Because of this, many tobacco users express the first coffin nail as the most important one of the twenty-four hours ( Corelli & A ; Hudmon, 2009 ) .
2.4 Hazards and Effectss of Smoking on Health
In Malaysia, smoke is responsible for one out of every five deceases that occur in this state ( Disease Control Division, 2003 ) . Consistent and convincing grounds associating the usage of baccy with several of serious cardiovascular, neoplastic and pneumonic diseases has been provided by many cohort surveies, case-control surveies, and other informations beginnings ( Disease Control Division, 2003 ) . Smoke is recognized to rush the coronary artery disease procedure, which will contributes to the chronic cardiovascular disease such as congestive bosom failure, coronary bosom disease, aortal aneurism, and cerebrovascular disease ( Corelli & A ; Hudmon, 2009 ) . By smoking, it may besides increases the hazard for developing acute cardiovascular events such as shot, sudden decease and myocardial infarction ( Corelli & A ; Hudmon, 2009 ) . In United States, lung malignant neoplastic disease is the taking cause of cancer-related mortality for both sexes ( Corelli & A ; Hudmon, 2009 ) . Secondhand smoke or inactive fume exposure may besides lend to several diseases among nonsmoking kids and grownups ( Corelli & A ; Hudmon, 2009 ) .
Pregnant adult females are besides vulnerable to smoking wellness hazard. Exposure to nicotine contained in the coffin nail fume can take to increase of ectopic gestation, low birth weight, increased hazard of self-generated abortion, and sweetening in perinatal mortality, aortal blood flow and bosom rate and decreased uterine blood flow and external respiration have been reported in the foetus ( Lacy et al. , 2010 ) . Prenatal smoke is responsible for about 18 per centum of instances of low birth weight and moreover, it can besides heighten hazard of respiratory distress syndrome, premature bringing and sudden baby decease syndrome ( Disease Control Division, 2003 ) . The most strongly documented inauspicious consequence of smoking during gestation is intrauterine growing deceleration ( Disease Control Division, 2003 ) .
In patients with lung, caput and cervix malignant neoplastic disease, which are successfully treated, but continue to smoke, hold a higher hazard for 2nd malignant neoplastic disease ( Disease Control Division, 2003 ) .
2.5 Smoking surcease aids and intercession
In order to diminish mortality and morbidity associated with tobacco-related diseases, smoking surcease intercession is an of import component of an overall baccy control plan ( Disease Control Division, 2003 ) . Harmonizing to Disease Control Division ( 2003 ) , there are two classs of clinical intercession for individual that willing to discontinue smoke which are brief clinical intercession and intensive clinical intercession. The first one, which is brief intercession can be subdivided into pharmacological, non-pharmacological or combination of several agents ( Disease Control Division, 2003 ) . For non-pharmacological intercession, it consists of five major stairss which are called the “ 5A ‘s ” which are ask, advice, buttocks, aid and arrange ( Disease Control Division, 2003 ) . For pharmacological intercession, it consists of several agents that have been proved to be effectual and have been suggested as first line agents for pharmacotherapy including nicotine replacing therapy ( NRT ) such as nicotine gum, nicotine spot and nicotine inhalator and besides sustained release ( SR ) bupropion ( Disease Control Division, 2003 ) . In intensive clinical intercessions, the continuance of single intervention Sessionss and the sum of intervention Sessionss are increasing and there are specialised behavioral therapies ( Disease Control Division, 2003 ) . The behavioral therapy can be categorized into practical guidance such as stress direction, intra-treatment and extra-treatment societal support ( Disease Control Division, 2003 ) . It is said that this type of intercession is more efficient than brief intercession ( Disease Control Division, 2003 ) .
For kids and striplings, it is shown that reding and behavioral therapies are more effectual and recommended for them ( Disease Control Division, 2003 ) . Whereas, for grownups ages 50 and older, reding intercessions, physician advice, telephone guidance and the nicotine spot are shown to be effectual ( Disease Control Division, 2003 ) .
Many tobacco users are sing a trouble in discontinuing smoke due to the presence of nicotine backdown symptoms following disconnected surcease of baccy usage ( Bansal et al. , 2004 ) . Nicotine replacing medicines including nicotine spot, inhalator, lozenges, gum, and nasal spray have been shown to relieve backdown symptoms during first phases of smoking surcease and they improves discontinuing rates in clinical tests ( Bansal et al. , 2004 ) .
The short-run use of nicotine that contained in the nicotine replacing therapy presents really little hazards compared with possible jeopardies of continued smoke, even in individuals with bosom disease ( Mooney, Leventhal & A ; Hatsukami, 2006 ) . Therefore, tobacco users should non worry to utilize the nicotine replacing therapy to discontinue smoke. However, for pregnant adult females, the usage of nicotine replacing medicines to help them in quit smoke has non been sufficiently studied ( Lacy et al. , 2010 ) . Therefore, nonpharmacologic interventions are more recommended for them in quit smoke ( Lacy et al. , 2010 ) .
2.5.1 Mechanism of Action of Nicotine Replacement Merchandises
Basically, nicotine is a naturally-occuring alkaloid that exhibits their major effects through stimulation of ganglia ( Lacy et al. , 2010 ) . It is a powerful stimulation of ganglionic and cardinal nervous system through nicotine-specific receptors ( Lacy et al. , 2010 ) . Biphasic actions are observed depend on the dosage of nicotine administered ( Lacy et al. , 2010 ) . In little doses of nicotine, the primary consequence of nicotine is stimulation of all autonomic ganglia, whereas, in larger doses of nicotine, initial stimulation is followed by transmittal encirclement ( Lacy et al. , 2010 ) . Biphasic effects are besides proved in the adrenal myelin, in which in little doses, it may do a catecholamines release, and oppositely in big doses, it may suppress the release of catecholamines as a response to splanchnic nervus stimulation ( Lacy et al. , 2010 ) . Central nervous system stimulation is illustrated by shudders and respiratory excitement, but in larger doses, paroxysms and respiratory failure may happen which are secondary to cardinal palsy and peripheral encirclement to respiratory musculuss ( Lacy et al. , 2010 ) .
Nicotine Replacement Products enhances success for smoking surcease by diminishing the physical backdown symptoms related with smoking surcease while the tobacco users focuses on seting their behaviour and managing with the psychological facet of discontinuing ( Corelli & A ; Hudmon, 2009 ) . Furthermore, because the oncoming of action for this medicines is non every bit fast as that of nicotine contained in coffin nail, smokers become less accustomed to the blink of an eye and reenforcing effects of inhaled baccy ( Corelli & A ; Hudmon, 2009 ) .
2.6 People ‘s cognition on smoking wellness hazards
Harmonizing to Disease Control Division ( 2003 ) , one of the grounds for a individual unwilling to do a quit effort is because of information missing sing the harmful effects of baccy. Whereas, the comparative deficiency of attempt to better Tell and educate tobacco users sing the merchandises that they use is partially the consequence of common premise that tobacco users are already better informed about the smoke wellness hazard ( Cummings et al. , 2004 ) . It does non intend that people are adequately informed about smoke in manner that may impact their smoke behaviour if they merely have general consciousness of smoking wellness hazard ( Cummings et al. , 2004 ) . Even though sweetening in perceptual experience of hazard are non invariably adequate to diminish smoking on their ain, betterment in wellness cognition are greatly related with decreases in smoking induction, sweetening in discontinuing behaviour and long-run abstention from smoking ( Jilan et al. , 2010 ) . However, harmonizing to Poureslami ( 2003 ) , being knowing about smoking ‘s bad consequence on wellness is deficient to advance behavior alterations. His survey shown that belief and alteration in attitude are needed to optimise behaviour and to promote healthy life style ( Poureslami, 2003 ) .
In the survey of Wang & A ; Annette ( as cited in Jilan et al. , 2010 ) , they conducted a survey among industrial workers in Shanghai and revealed that merely 53 per centum of tobacco users and 76 per centum of non-smokers were recognize that smoke can be harmful to wellness, and merely 51 per centum of tobacco users reported that smoke can take to lung malignant neoplastic disease.
In the survey of Taylor et Al. ( as cited in Lim et al. , 2009 ) , they found that tobacco users particularly heavy tobacco users have a positive attitude toward smoking when compared to formers and non tobacco users.
In a survey conducted by Lim et Al. ( 2009 ) , they had conducted a survey to happen out the degree of cognition and to understand respondents ‘ attitude towards smoke and besides to happen out how sociodemographic background, smoking position and smoke wellness hazard can impact respondents ‘ attitudes toward smoking. From their survey, they found that cognition and attitude differ based on position of smoke and tobacco users possess a low degree of cognition and they have more positive attitudes compared with non-smokers ( Lim et al. , 2009 ) . Besides that, they were besides found that degree of instruction was greatly associated with cognition and attitude tonss ( Lim et al. , 2009 ) . The most surprising informations found was female respondents whose cognition ‘s degree on jeopardies of smoke is low ; nevertheless, they show more negative attitudes towards smoking in comparing with males respondents ( Lim et al. , 2009 ) .
In the survey conducted by Cummings et Al. ( 2004 ) , they were evaluated on the tobacco users ‘ belief on smoking wellness hazard and the advantages of smoke filtered and low-tar coffin nails, and besides tobacco user ‘s consciousness and involvement in seeking alleged reduced hazard baccy merchandises and nicotine medicines. They stated that when they asked the respondent whether they consider themselves to be better informed sing the smoke wellness hazard, 94 per centum of them answered it confidently ( Cummings et al. , 2004 ) . However, from the cognition indices in which each respondent was assessed their degree of cognition by giving a mark for the right responses, 39 per centum of them either answered falsely or responded “ make non cognize ” to the inquiries sing smoking wellness hazard ( Cummings et al. , 2004 ) . These consequence shows that some of the respondents think they are better informed but really, there is much information that they did non cognize sing the smoke wellness hazard. Besides that, the writers besides found that tobacco users who believed they will discontinue smoke in the following twelvemonth were more knowing about smoke, whereas tobacco users who believed that they will discontinue smoke before sing serious wellness jobs were less knowing about smoke ( Cummings et al. , 2004 ) .
In the survey conducted by Jilan et Al. ( 2010 ) , in which the writers where assessed fluctuations between the wellness cognition of current, former and ne’er tobacco users on smoke and the consequence of wellness cognition consciousness on tobacco users ‘ purpose to halt smoke, they found that current tobacco users in China were less likely to admit the wellness consequence of smoke compared to former and non tobacco users. They besides found that current tobacco users who had consciousness of wellness consequence of smoking were more prone to hold purpose to halt smoke ( Jilan et al. , 2010 ) .
2.7 People ‘s cognition of smoking surcease aids
Some of the tobacco users have a uncertainty sing the effectivity of nicotine replacing therapy and they believe that discontinuing on their ain, without aids such as guidance and medicine, is every bit or much more effectual than assisted surcease ( Mooney, Leventhal & A ; Hatsukami, 2006 ) . They have misinformation and deficiency of information sing the smoke surcease assistances particularly approximately nicotine replacing therapy. Besides that, some of tobacco users have misperception that nicotine is a primary cause of tobacco-related wellness job ( Mooney, Leventhal & A ; Hatsukami, 2006 ) . Therefore, this lead to a uncertainty among tobacco users to utilize nicotine replacing therapy to assist them in smoking surcease. Harmonizing to Bansal et Al. ( 2004 ) , they besides stated that misperceptions on the nicotine ‘s wellness hazard and safety and effectivity of nicotine replacing therapy may do some tobacco users afraid and concerns to sing the usage of these medicines to help them in smoking surcease.
Harmonizing to Bansal et Al. ( 2004 ) , in order to increase cognition sing on safety and efficaciousness of nicotine medicines, loath tobacco users should be offered a opportunity to seek nicotine medicines on a test footing, in which finally enhance usage of these medicines for smoking surcease. Unfortunately, the writers stated that cognition of nicotine wellness hazard and how the medicines work, even among those who had antecedently used nicotine medicines, was still deficient ( Bansal et al. , 2004 ) .
Harmonizing to the survey by Cummings et Al. ( 2004 ) , 56 per centum of respondents either answered falsely or responded “ make non cognize ” sing the cognition on nicotine medicines. The writers besides revealed that a individual with past experience of utilizing nicotine medicines prone to be more knowing sing the safety and efficaciousness of these merchandises ( Cummings et al. , 2004 ) .
Harmonizing to the survey by Mooney, Leventhal & A ; Hatsukami ( 2006 ) , tobacco users with more terrible dependance which perceived larger demand for intervention of smoking surcease yet had lower accurate cognition sing the disease-causing function of nicotine. The survey besides found that participants who had stop smoke antecedently for a longer continuance of clip had a more favourable position of smoking surcease intervention and nicotine replacing therapy ( Mooney, Leventhal & A ; Hatsukami, 2006 ) .
In the survey of Etter & A ; Perneger ( as cited in Bansal et al. , 2004 ) , a survey on about 500 tobacco users and former tobacco users was conducted in order to place their attitudes toward the usage of nicotine medicines. From this survey, they found that many tobacco users were worried to utilize nicotine medicines due to safety concern ( Bansal et al. , 2004 ) . From this survey, merely 16 per centum of them were agreed that nicotine medicines assist people in smoking surcease ( Bansal et al. , 2004 ) . Besides that, the survey besides revealed that those who had antecedently used nicotine medicines and those most interested to discontinue smoke in the hereafter have the highest cognition on nicotine medicines ( Bansal et al. , 2004 ) .
In planing a cross sectional study on cognition of current tobacco users, former tobacco users and non tobacco users on smoking wellness hazards and smoking surcease, few sets of validated questionnaires had been adopted, modified and being distributed to respondents in two selected locations which are UiTM in Puncak Alam and Shah Alam.
Partially of the questionnaires was adopted from validated questionnaire in a survey entitled Are tobacco users adequately informed about the wellness hazards of smoke and medicative nicotine by Cummings et Al. ( 2004 ) . Besides that a validated questionnaire was besides adapted from a survey entitled Smoking and Nurses in New Zealand. ASH-KAN Aotearoa: Appraisal of smoking history, cognition and attitudes of nurses in New Zealand by Wong et Al. ( 2007 ) and besides a validated questionnaire from a Fagerstrom Test for Nicotine Dependence by Heatherton et Al. ( 1991 ) . Some alterations had been done harmonizing to the suitableness of the subject, aim of the survey and smoke position.
The questionnaire consists of four parts which cover demographic informations, smoke position, degree of nicotine dependance and cognition index. Knowledge index is divided into several countries which are smoking wellness hazards, content of coffin nail fume, safety of nicotine, low-tar and filter coffin nails, additives contained in coffin nails and nicotine medicines. The four chief subdivisions had been chosen to be included into the questionnaires in order to carry through the aims of the survey as stated earlier.
Table 3.1 Description of each portion in the questionnaire
Degree of nicotine dependance
The respondents ‘ cognition on several countries will be measuring utilizing multiple pick inquiries or near complete inquiries. Mostly of the inquiries in the questionnaire will be done utilizing multiple pick inquiries or stopping point ended inquiry in order to do respondents easier to reply the inquiries in the questionnaire. In the cognition indices, respondents have to take merely one correct reply for each statement. In the portion B and C of the questionnaire, merely current tobacco users have to reply it whereas in the portion A and D, all respondents are required to carry through the reply.
3.3 Sample of survey
A convenient sampling will be conducted where it involved any of the pupils in UiTM Shah Alam and Puncak Alam Campus. The sample size intended for this survey is about 600 samples where 300 samples are from Shah Alam Campus and another 300 samples from Puncak Alam Campus.
Further divided into following group:
3.4.1 Inclusion standards
1. Students who are a current tobacco users.
2. Students who are a former or an ex- tobacco users.
3. Students who are make non smoke at all or none tobacco users.
3.4.2 Exclusion standards
1. Students who have household members or friends who are working in a
nicotine replacing drug companies or baccy companies.
3.5 Data Collection
Data will be collected from two selected UiTM campuses which are UiTM Shah Alam at Shah Alam, Selangor and UiTM Puncak Alam at Kuala Selangor, Selangor. The questionnaires will be distributed every bit in both campuses. All the respondents will be asked to finish the questionnaire and engagement will be voluntary. All respondents will be given a sufficient clip to reply every inquiry in the questionnaire. A pilot survey among friends will be done prior to questionnaire distribution.
3.6 Data processing and statistical analysis
In the portion C of the questionnaire, the degree of current tobacco users ‘ dependence to nicotine will be define by hiting the responses given to each inquiry based on the marking that had been assigned in the Fagerstrom Test for Nicotine Dependence. In the portion D of the questionnaire, the cognition index for a each capable country will be define by hiting the responses given to each statement on that topic as either correct or incorrect or make non cognize and so ciphering the amount of right responses for all inquiries assigned to the index. Descriptive statistics, for cases such as simple per centum and agencies, will be used to mensurate the cognition of respondents on smoking wellness hazards and smoking surcease aids available in Malaysia. The independent t-test and analysis of discrepancy ( ANOVA ) will be executing to find the difference in cognition tonss between different groups. A additive arrested development analyses will be utilizing to find the relationship among demographic, smoking position and degree of dependence with the different cognition indices. All statistical trials will be done utilizing SPSS package version 17.0. Microsoft Office that will be used is Microsoft Excel.